Carter Center Congratulates Colombia as First in the Americas to Eliminate River Blindness

BOGOTÁ, COLOMBIA… Former U.S. President Jimmy Carter today congratulated President Juan Manuel Santos and the people of Colombia for becoming the first of six countries in the Americas to eliminate river blindness. The official ceremony was held today in Bogotá. River blindness, also known as onchocerciasis, is a parasitic disease that can cause intense itching, eyesight damage, and irreversible blindness. River blindness is transmitted by small black flies that breed in rapidly flowing rivers.

"Colombia's achievement demonstrates that a future free from river blindness is possible for everyone in the Americas, and is an inspiration for the Carter Center's recent commitment to not only control the spread of river blindness but to eliminate the disease wherever we are fighting it in Africa," said former U.S. President Jimmy Carter, founder of The Carter Center, which has led the campaign to wipe out the disease in Latin America through its Onchocerciasis Elimination Program for the Americas (OEPA). Since 1986, The Carter Center has continued to pioneer multiple disease elimination approaches in Africa and Latin America.

Colombia Minister of Health and Social Protection Dr. Alejandro Gaviria Uribe, President Carter, and former First Lady Rosalynn Carter were joined at the ceremony by representatives of the Colombia government, the Carter Center's River Blindness Elimination Program and the Carter Center's OEPA, Colombia's National Institute of Health, and partners including the Pan American Health Organization (PAHO), Merck/MSD, the Lions Clubs International Foundation, and the Bill & Melinda Gates Foundation.

Colombia is the first country in the Americas to eliminate river blindness and is the first country in the world to apply for and be granted verification of elimination of river blindness by the World Health Organization (WHO).

VERIFICATION PROCESS Colombia, together with its partners OEPA and PAHO, which is a regional body of the WHO, eliminated river blindness using a strategy of twice per year community-wide administration of the medicine ivermectin (Mectizan®, donated by Merck) to all people in the afflicted area. Community volunteers, leaders, and promoters played a major role in health education and distribution of the drug and were largely responsible for sustaining it over the course of 17 years. Mectizan treatments were stopped in 2008, after which three years of post-treatment surveillance were required by the WHO to determine if transmission of the parasite would recur before elimination could be declared.

A team of international experts visited Colombia under the auspices of the WHO to verify the elimination of the disease from the country. On April 5, 2013, WHO Director-General Dr. Margaret Chan provided Colombia with official notification that WHO verified elimination of the disease. The WHO is the only organization that can officially recognize the elimination of a disease.

Community leaders and promoters in the formerly river blindness endemic area known as López de Micay played a critical role in success of the program. Local health workers and dedicated volunteers supervised the administration of Mectizan. Together, the community encouraged local participation in river blindness prevention events and activities and disseminated health information.

"The Colombia river blindness program did more than just rid the country of a horrible disease. The community focus of the program empowered people to take on other community improvement projects, like improving access to safe water and basic sanitation, providing better nutrition and health care, and even constructing a school. The river blindness elimination program ended a disease and created hope," said Alba Lucia Morales, health education adviser with the Center's OEPA and a Colombian national who has observed development in the formerly endemic area over nearly two decades.

Since 1996, the Carter Center's peace and health programs have partnered with the Colombian people to improve health and prevent and resolve conflicts by hosting dialogue forums to reduce tensions between neighboring countries, awarding local journalism fellowships to reduce the stigma of mental illness, and breaking the cycle of transmission for river blindness.

OEPA'S STORY When the OEPA program was launched in 1993, an estimated 500,000 people in the Americas were at risk of river blindness in six countries: Brazil, Colombia, Ecuador, Guatemala, Mexico, and Venezuela. Today, as the result of highly successful national programs, transmission of this once 'neglected' tropical disease has been broken in 96 percent of the region and no one need fear becoming blind from river blindness in the Americas. Mexico and Guatemala, formerly the region's two most endemic countries, have interrupted transmission of river blindness, halted Mectizan treatment, and begun their post-treatment surveillance. Ecuador, having completed its three years of post-treatment surveillance, has filed a request to WHO for a verification team visit. Transmission of the disease remains only in the hard-to-reach border area between Venezuela and Brazil in Amazon rainforest.

Partners in the effort to wipe out river blindness from the Western Hemisphere include: thousands of community-based volunteers, the ministries of health of the six endemic countries, The Carter Center, the U. S. Centers for Disease Control and Prevention (CDC), the PAHO, Merck and the Mectizan® Donation Program, the Bill & Melinda Gates Foundation, the United States Agency for International Development (USAID), the Lions Clubs International Foundation and the local Lions Clubs from the six countries, Mr. John Moores and the former River Blindness Foundation, the OPEC Fund for International Development, the Alwaleed Bin-Talal Foundation, the Inter-American Development Bank, several universities in Latin America and the United States, and many other individual donors.

WHAT'S NEXT FOR RIVER BLINDNESS IN THE AMERICAS AND AFRICA
The progress in the Americas has been a beacon of hope for river blindness elimination efforts in Africa, where more than 120 million people are at risk and hundreds of thousands have been blinded by the condition.

"The approach to eliminate river blindness in the Americas is being adapted by African countries, where over 99 percent of the suffering from river blindness in the world occurs," said Dr. Mauricio Sauerbrey, director of the Carter Center's OEPA Program. "Colombia has demonstrated the essential elements of a successful river blindness elimination program - hard work, community engagement, attention to detail, data-driven, strong partnerships, and prolonged political commitment."

Since absorbing the River Blindness Foundation in 1996, The Carter Center has assisted the ministries of health in the six Latin American countries, and in Africa assists Ethiopia, Nigeria, Sudan, and Uganda. By 2012, The Carter Center had assisted in delivery of approximately 172 million cumulative treatments of Mectizan through community-based channels worldwide. After demonstrating in Latin America and Africa that river blindness transmission can be interrupted through health education and twice-a-year Mectizan drug treatments, the Center announced in July 2013 that it had officially added the word elimination to its program name (River Blindness Elimination Program) to reflect the new focus of its intervention efforts. Moving from control to elimination in the areas where the Center assists is a turning point in the Carter Center's river blindness strategy, requiring that intervention efforts intensify to wipe out the disease once and for all.